periodontal disease and immunology (complete)

Question 1

what are the components of the periodontium

Answer 1

gingiva
gingival attachement
cementum
periodontal ligament
alveolar bone

Question 2

which parts of the periodontium are tooth supporting structures

Answer 2

cementum
periodontal ligament
alveolar bone

Question 3

what are the cells surrounding the periodontal ligament

Answer 3

connective tissue cells
epithelial rest cells
immune system cells (Neutrophils, lymphocytes, macrophages, mast cells, eosinophils)

Question 4

what is periodontal disease

Answer 4

a broad group of pathological alterations to the periodontal tissue

Question 5

what is the only etiology of periodontal disease

Answer 5

bacterial plaque

Question 6

what is bacterial plaque

Answer 6

the colonization of subgingival regions by specific groups of organisms (bacterial mass)

Question 7

where does bacterial plaque attach

Answer 7

tooth surface above and below the gingival margin

Question 8

what are the direct effects of bacterial plaque on the periodontium

Answer 8

invasion
release of exotoxins
cell constituents
enzymes (proteases)

Question 9

what are the indirect effects of bacterial plaque on the periodontium

Answer 9

immunological and other host responses (often destructive)

loss of periodontal tissue

Question 10

what are the two types of periodontitis

Answer 10

chronic and aggressive

Question 11

what is periodontitis

Answer 11

an inflammation based infection to the supporting structures of the teeth

Question 12

what effect do systemic diseases have on periodontitis

Answer 12

they modify it

Question 13

which type of periodontitis is most common in adults

Answer 13

chronic

Question 14

is the severity of chronic periodontitis consistent with the plaque and calculus formation

Answer 14

yes

Question 15

what happens to the tissues in chronic periodontitis

Answer 15

they may be red or purplish

you may lose attachment and bone

Question 16

how quickly does chronic periodontitis progress

Answer 16

slowly or moderately

Question 17

is the severity of aggressive periodontitis consistent with the plaque and calculus

Answer 17

nope

Question 18

how fast is the destruction of tissue progression in aggressive periodontitis

Answer 18

rapid

Question 19

are there genetic factors involved in aggressive periodontitis

Answer 19

yes

Question 20

what bacteria is most commonly associated with aggressive periodontitis

Answer 20

actinobacillus actinomycetemcomitans

Question 21

what is the activity of PMNs and macrophages like in aggressive periodontitis

Answer 21

abnormal PMN function and hyperresponsive macrophages

Question 22

what are the two kinds of aggressive periodontitis

Answer 22

Localized (LAP)

generalized (GAP)

Question 23

which type of aggressive periodontitis has a strong Ab response, which type has a poor Ab response

Answer 23

localized has a strong Ab response

generalized has a weak Ab response

Question 24

what are the characteristics of localized aggressive periodontitis

Answer 24

1. early onset
2. associated with actinobacillus actinomycetemcomitans
3. abnormal neutrophil function
4. destroys around 1st molars and incisors
5. AKA juvenile periodontitis

Question 25

what are the characteristics of generalized aggressive periodontitis

Answer 25

1. rapid attachment and bone loss 2. no obvious symptoms of systemic disease 3. destruction isn't proportional to plaque 4. genetic factor 5. specific bacteria 6. early onset

Question 26

are all bacterial plaque equally pathogenic

Answer 26

nope

Question 27

what are the bacteria associated with periodontitis

Answer 27

Porphyromonas gingivalis Prevotella intermedia Bacteroides forsythus Campylobacter rectus

Question 28

what bacteria is associated with aggressive periodontitis

Answer 28

Actinobacillus actinomycetemcomitans (Aa)

Question 29

what are the virulence traits of periodontal pathogens,

Answer 29

``` proteases hemagglutinins LPS Fimbriae Polysaccharide capsule ```

Question 30

what do proteases do for periodontal pathogens

Answer 30

degrade host proteins

Question 31

what do hemagglutinins do for periodontal pathogens

Answer 31

they are responsible for bacterial binding to the host cell receptors

Question 32

what does LPS do for periodontal pathogens

Answer 32

slightly endotoxic

Question 33

what does Fimbriae do for periodontal pathogens

Answer 33

helps in adherence, colonization, and periodontal destruction

Question 34

what does the polysaccharide capsule do for periodontal pathogens

Answer 34

inhibit phagocytosis and MAC medaited cytolysis

Question 35

how does P. gingivalis induce inflammation and bleeding and why

Answer 35

hemagglutinins and proteases lyse RBCs and extract the nutrients for rapid growth

Question 36

what do the proteases of periodontal pathogens lyse

Answer 36

RBCs serum Abs complement proteins cytokines

Question 37

what is responsible for bone resorption

Answer 37

PGE2

Question 38

how do you combat PGE2 and bone resorption

Answer 38

NSAIDs and dexamethasone

Question 39

early periodontal lesions are characterized by

Answer 39

T-cells and macrophages

Question 40

established and advanced periodontal lesions are characterized by

Answer 40

B cells and plasma cells

Question 41

what controls the progression from T-cells and macrophage in early periodontal lesions to B-cells and plasma cells in advanced periodontal lesions

Answer 41

host Th-derived cytokines

Question 42

early clinical gingival lesions correlate with which type of immune response and which cytokines

Answer 42

TH1 type response with IL-12 and IFN-y protective immunity

Question 43

established gingival lesions correlate with which type of immune response and which cytokines

Answer 43

TH2 response IL-4, IL-10, IL-13 chronic periodontitis

Question 44

what type of immune response leads to aggressive periodontitis

Answer 44

TH-1 dependent Ab type | high IgG2